Hx: chest and neck pain.
What are the important findings? Recommendations?
Diagnosis? 🤔
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #chestrad
We clearly see the extensive stranding throughout the anterior mediastinal fat, with severe narrowing of the left bracheocephalic vein and left jugular vein.
If you are observant you may see narrowing on the R as well 😉
Infectious thrombophlebitis of the internal jugular vein in the setting of pharyngitis/tonsilitis
-Male predominance
-generally 16-25 years old
-80% caused by Gram (-) Fusobacterium necrophorum but can be polymicrobial even including MRSA
Jugular vein thrombosis. US generally easiest and most straight forward but can be limited within the chest
CT/MR helpful for more central venous evaluation and to identify source/site of primary infection (pharyngeal or tonsillar)
Complications: Pulmonary Septic emboli and systemic dissemination
Treatment: Anticoagulation and IV Abx. Mortality rates can be as high at 18%.